The echocardiogram in this patient demonstrated a severely enlarged left atrial size with echogenic “smoke”. The cranial and caudal mitral valve leaflets presented normal linear structure, extension in systole, and union in diastole. No significant dystrophic or vegetative changes were noted. The left ventricle was mildly thickened with poor contractility. The left ventricular free wall was stiff and hypokinetic. The left ventricular septum presented the majority of the contractility. Myocardial remodeling was evident. The left ventricular outflow tract demonstrated normal laminar flow without evidence of hemodynamically significant insufficiency or excessive outflow velocity. Subjective assessment of the right atrium and auricle revealed normal size, structure and content. No evidence of masses was noted. Tricuspid valvular assessment demonstrated linear morphology. The right ventricle was of normal size (1/3 diameter of LV), chordae structure, myocardial echogenicity and thickness. No evidence of dilation nor restriction was noted. Pulmonic tract assessment revealed normal valve structure, laminar flow, and diameter (approx.1:1 pa/ao ratio. Pleural and pericardial effusion was noted. No echographically detectable evidence of infiltrative disease was visible. The mediastinum was free of masses in the visible window. The diaphragm was visualized without interruption. Periodic arrhythmia was noted during the exam.